Severe Hemorrhagic Cystitis Associated with BK Polyoma Virus Infection Following Lung Transplantation

BK polyoma virus-associated hemorrhagic cystitis has been described in patients who have had renal, bone marrow and cardiac transplantation. We report the first case of hemorrhagic cystitis associated with the BK virus in a 51 year old woman with scleroderma, who received bilateral lung transplantation. The pathological findings of the bladder were large cells with enlarged nuclei and scant cytoplasm (Decoy cells). The diagnosis was confirmed by immunohistochemical stains of the urinary bladder tissue and by blood and urine PCR. The patient required a cystectomy.